Maximum surgical blood order schedule in urology surgery

Abstract

Aim: To improve patient blood management (PBM), a special system of collecting and testing blood units has been developed. It defines the maximum number of allogeneic red blood cell components necessary for certain surgical interventions. This system is referred to as "The Maximum Surgical Blood Order Schedule" (MSBOS). The aim of the study was to evaluate the rationality of red blood cell consumption during urological surgeries. Materials and Methods: During the course of one year, a retrospective study was conducted on 617 patients. The study included 185 women and 432 men, with a median age range of 60 years old (ranging from 45 to 75 years old). The consumption of red blood cell units was evaluated in relation to the primary indication and type of surgery, preoperative data on hemoglobin values, and coagulation tests. Results: The overall C:T ratio was 4.2, which corresponds to 24% of transfused units in relation to the number of cross-match tests performed. A statistically significant difference in the average related to the age was observed between the subjects in whom there was irrational (64.65±9.49 years) and those in whom there was a rational use of red blood cells. A statistically significant difference was also observed in the frequency of different primary diagnoses according to the International Diseases Classification) and in relation to the values of hemoglobin and prothrombin time (PT) between the group with rational and irrational use of red blood cells. Conclusion: The obtained data showed unreasonable use of RBC based on the C:T ratio and therefore the necessity of introducing of PBM system as well the necessity to revise the existing protocols for red blood cell demand according to indications and to improve patient preparation in order to minimize the use of allogeneic red blood cells.